Specialised physiotherapy for in-patients with diabetes

Ms Jacqueline Kay1, Mr Scott Edwards2, Professor Peter Colman3,4, Mr Spiros Fourlanos3, Ms Katie Marley5, Ms Samantha Plumb6

1Physiotherapy Department, Melbourne Health, Parkville, Australia, 2Allied Health Department, Melbourne Health, Parkville, Australia, 3Department of Diabetes and Endocrinology, Melbourne Health, Parkville, Australia, 4The University of Melbourne , Parkville, Australia, 5Diabetes Education Service, Department of Diabetes and Endocrinology, Melbourne Health, Parkville, Australia, 6Royal Melbourne Hospital, Parkville, Australia

Aim: The Department of Health and Human Services (Victoria) funded a six-month position to establish the feasibility of a specialised Physiotherapy position in diabetes, and the impact on patient outcomes. This was following an internal audit showing increased length of stay (LOS) and readmission rates for in-patients with diabetes.

Method: Prospective case series. Inclusion criteria: in-patients with a primary or secondary diagnosis of diabetes, body mass index greater than 30kg/m2, and/or predicted LOS greater than 7 days. Exclusion criteria: refused intervention, already fulfilling Australian physical activity guidelines, were uncontactable, readmitted to hospital at six-weeks post-discharge, medically unable to exercise post-discharge, or deceased. Participants were allocated into intervention and non-intervention groups due to large referral numbers. Both groups received standard Physiotherapy care, with the intervention group (IG) receiving further exercises and consultation (establishing exercise goals, education, and problem-solving barriers to exercise). All participants completed an International Physical Activity Questionnaire at baseline and six-weeks post-discharge, and a satisfaction survey.

Results: During the intervention period 56 patients were recruited into the IG (N=36) and non-intervention (N=20) groups. Demographic data of the groups were comparable. The IG had a median LOS of 4.5 days less, and readmission rate 11% lower than the non-intervention group. At six-weeks post-discharge, participants in the IG were participating in an average of 62 minutes more moderate exercise per week.

Significance of the findings to allied health: Feasibility of this position was demonstrated, with considerable benefits on LOS, and readmission rates. IG participants completed more exercise at follow-up, with wider benefits for patients and health providers in the area.